Provider Demographics
NPI:1811184104
Name:HUDSON, KARLA SUE (MHS, OTR/L)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:SUE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4394 CENTRAL AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1383
Mailing Address - Country:US
Mailing Address - Phone:708-829-7676
Mailing Address - Fax:708-496-3422
Practice Address - Street 1:6500 W 65TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4962
Practice Address - Country:US
Practice Address - Phone:708-496-1515
Practice Address - Fax:708-496-3422
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist